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Peptic Ulcer Disease

 
 
 
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Overview

Peptic ulcer disease is a common condition where ulcers may form in the stomach or duodenum. This may be as a result of Helicobacter pylori infection, medications, stress or dietary factors.

Pathogenesis

  • Causes of Peptic Ulcer Disease

  • Helicobacter pylori infection
  • Medications - NSAIDs, steroids, bisphosphonates, chemotherapy
  • Zollinger-Ellison syndrome
  • Gastric malignancy
  • Acute illness

Manifestations

  • Complications of Peptic Ulcer Disease

  • Upper GI bleeding
  • Perforation
  • Gastric outlet obstruction

Management

  • Management of Peptic Ulcer Disease

  • Pharmacologic

  • H pylori eradication - triple or quadruple therapy
  • Proton pump inhibitors - omeprazole, esomeprazole, pantoprazole
  • H2 receptor antagonists - ranitidine, nizatidine
  • Interventional

  • Endoscopic management - injection of adrenaline, coagulation, endoscopic clipping
  • Surgical management (rare) - vagotomy, partial gastrectomy
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